Thursday, April 2, 2015

Back to The Oaks

While I was home I thought it would be a good idea to see some practice, my first EMS as a vet student, just to remind me why I was at vet school and keep me motivated for the final half of this semester before the dreaded Finals!

I texted a friend who's a small animal vet at The Oaks, the first place I ever saw practice at, asking what days they were open over Easter and if it would be possible to spend a day with them - the reply came quickly that I could go the day after I got home, Thursday.

I arrived at 8am ready for consults to start at 8:30am where we had post-op checks, vaccinations and a dog who had just gone off his feet who Andy admitted for a neurological examination.

I then went out back to once prep and theatre started; the board was pretty full and Brian was doing most of the operations today.
We started off with two Fine Needle Aspirates (FNA's) on dogs, both which appeared to be fatty lumps rather than anything sinister but were sent off to the lab which can help make a diagnosis or rule out more sinister things like cancer.
Brian stressed the importance of taking true representations of the lumps, swap needles between each biopsy and importance of labelling slides correctly!

Next up we had neuters for a local cat charity - two castrates, one of which came in as a possibly pregnant feral cat but turned out to be a quite friendly little man, followed by a spay on a young female who once turned out to be pregnant once we'd opened her up. 
I've seen pregnant cats spayed before so when Brian asked what I thought about the ethics I was ready with an answer; the procedure is being done for birth control purposes so leaving her to have the kittens on the street would only make this situation worse as not only would she have more kittens in the future but so would her kittens continue the cycle as there's no guarantee that she would be trapped again in order to be speyed in the future.

Before he started the spey Brian the vet asked if I'd like him to talk me through the op, I said I'd seen loads before so he was ok, he double checked I was sure, yep... and so said I had to talk him through what he was doing!
Luckily we did the female urogenital tract in Anatomy last week so it was fresh in my mind and I remembered the abdominal muscles as he was cutting through those. He pointed out that I was naming everything in Latin rather than English and I think (hope!) he was impressed that I could name all the structures.
Andy asked me later on about the endocrine system and although I've done it all before it was years ago and I didn't have a clue! Once he explained it came straight back to me and made sense but I wouldn't have been able to come up with the answers by myself...

It looked like they were getting through the ops board just fine when a cat was admitted in a diabetic or hypoglycemic crisis. He looked a lot better than he had at home where he was circling around the living room, but we took a blood glucose and got a reading of 3.2; it should be between 5 and 15.
He was really cold so put in a cat kennel with a heat pad, some warmed smelly cat food to tempt him and we would repeat blood glucose an hour later.

The last op of the day was a dental on an English Bull Terrier with Cushings disease which is an endocrine disorder usually caused by a tumor on the pituitary gland which causes an excess of cortisone in the blood, affecting metabolism. Because of this they wanted to closely monitor her throughout the anesthesia and keep her on a drip to support the kidneys. 
They really struggled to place a catheter to get the drip in, tried both legs, took a break and then tried again - it said in her notes from 2 years ago that they really struggled back then too.
I monitored her heart and respiratory rates throughout the scale and polish and although they were lower or slower than expected, she was stable throughout and recovered just fine.

The diabetic cats blood glucose stabilised and as he was on insulin they adjusted his medication and timing and were going to monitor it closely for a while.

I really enjoyed the day and felt like I was able to help out and be useful rather than getting in the way, holding animals while they were injected or sedated, wiping down consult tables, helping to pre-med animals with the nurses before surgery and cleaning theatre ready for the next op.

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